A revised complaint with additional allegations in the class action lawsuit against skilled nursing facility Extendicare and its 16 facilities in the state of Washington [see list by city at end of release] was just filed (Case #2:08-cv-01332-JCC) in United States District Court, Western Washington Division, in Seattle.

The original complaint (Case #08-2-28645-2KNT), filed by The Garcia Law Firm of Long Beach, Calif., and Stritmatter, Kessler, Whelan, Coluccio of Seattle, Wash., in King County Superior Court in August 2008, alleges that Extendicare tells the public and prospective clients that it is operated in such a way that it meets the needs of its elderly and vulnerable adult residents by providing a certain standard of care. The complaint contends that in spite of the claims made on Extendicare’s websites and in its brochures and in other promotional materials, it is, in fact, cheating its residents and misrepresenting itself to prospective residents.

The suit was filed on behalf of Howard Steele as the personal representative for the estate of Lee Ann Steele and on behalf of all Washington citizens who resided in one of the company’s Washington facilities from July 1, 2004 through July 1, 2008.

“As people heard of the lawsuit, we started getting calls from family members and former Extendicare staff members, each with their own story of how bad their experience was with the company,” says plaintiff attorney Kevin Coluccio of Stritmatter, Kessler, Whelan, Coluccio. “These calls, combined with our own investigation, revealed a whole host of problems that we hadn’t even expected.”

New allegations include Extendicare’s “Green Flag Policy” or the “24/7 Extendicare Admission Policy.” This policy is comprised of three lists: “Green Flag,” “Yellow Flag,” and “Red Flag.” Various medical conditions are attributed to each list.

The “Green Flag” list includes such serious medical conditions as tracheotomies, gastric tubes, nasal gastric tubes, Dobhoff tubes, wounds, VAC therapy, chest tubes for drainage, colostomies, ileostomies, ureotomies, IV therapy, Hepatitis B, HIV. It also includes patients who are in restraints, need physical occupational or speech rehabilitation, chemotherapy, radiation, traction, or are an elopement risk. Presenting with any of these conditions qualifies them for “Automatic Admission/Always Yes Immediately,” states the 24/7 Extendicare Admission Policy.

By law, a skilled nursing facility must be able to provide the care and treatment you need and be sure you are not a danger to other residents before it accepts you. These admitting policies were designed for all 16 Washington Extendicare facilities by the corporate office in Milwaukee, Wisc. A patient could only be DENIED admittance if the corporate vice president approved.

“I don’t believe a corporate vice president in Milwaukee could possibly know if the local facility was able to handle the needs of the patient or if the patient should be in a hospital or another acute care facility,” says Long Beach, Calif., plaintiff attorney Stephen M. Garcia of The Garcia Law Firm. “It seems to me that the emphasis is on increasing the census in order to increase the profits, regardless of whether the prospective patient needed care the facility couldn’t give or if he were a felon or even a sex offender.”

Coluccio and Garcia also found that the corporate-mandated Resident Rights form given to incoming patients, and which they had to sign, violates Washington law. Extendicare’s form makes patients sign away their right to bring legal action for any potential liability for personal injury or losses of personal property. Washington law (§388-97-051 WAC) says that the resident has the right not to be asked or required to sign any such contract or agreement.

In the revised complaint filed today, Extendicare Health Services, Inc. was added as a defendant to Howard Steele, as the Personal Representative for the Estate of Lee Anne Steele v. Extendicare Homes, Inc.; Fir Lane Terrace Convalescent Center, Inc.; and Does 1 through 250, inclusive.

Extendicare Homes, Inc. is a subsidiary of Extendicare Health Services, Inc. and is the licensee of a number of long-term nursing facilities. In the United States, Extendicare Health Services, Inc., (EHSI), based in Milwaukee, Wisc., is a wholly owned subsidiary of the Canadian company Extendicare Real Estate Investment Trust (Extendicare REIT). The company (symbol: ALC) is listed on the New York Stock Exchange.

Extendicare Health Services, Inc. operates, according to its website, 191 senior care facilities in the United States with approximately 19,200 beds.

Extendicare’s problems seem to range across the country. A July 27, 2008 article in theMilwaukee Journal-Sentinel reported that Extendicare owns 26 nursing homes in Wisconsin. Twenty of them have been cited for at least one serious care violation in the past three years. The article also reports that in 2005, Extendicare paid $2.3 million to Wisconsin in a civil settlement over serious nursing home violations arising from the 2003 death of a resident. Its Sun Prairie home, Willows Nursing & Rehabilitation, was cited for poor care after two residents died. Willows paid $198,045 in state and federal fines; it also is on the federal list of the worst homes in the country.

Nevertheless, Extendicare is expanding in Washington. A July 12, 2007 article in theJournal of Business reported that it had received preliminary state approval to build a 120-bed facility on the South Hill in Spokane. The article said that the facility is expected to open in July 2009.

Washington FacilitiesThe Washington statewide average of citations for deficiencies by the Washington Departmentof Social and Health Services in all years quoted below was nine.

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